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101.
Rinat Gabbay-Benziv Amir Aviram Eran Hadar Rony Chen Ron Bardin Arnon Wiznitzer 《The journal of maternal-fetal & neonatal medicine》2017,30(16):1916-1919
Objectives: To evaluate pregnancy outcome following false diagnosis of fetal growth restriction (FGR).Methods: Retrospective analysis of all singleton term deliveries of appropriately grown fetuses (10–90th weight percentiles) in a single medical center (2007–2014). Elective cesarean-section, diabetes, and hypertension were excluded. Cohort was stratified based on third trimester sonographic estimated-fetal-weight (≥32 weeks). Women with false diagnosis FGR (<10th percentile) were compared with the rest (control). Induction of labor, cesarean deliveries, and short-term perinatal outcome were compared. Logistic regression analysis was performed to adjust outcome for birth weight and gestational age at delivery.Results: Of 34,474 pregnancies, 415 were falsely diagnosed as FGR (1.2%). Women in study group delivered earlier (38.6?±?1.1 versus. 39.0?±?0.9) with lower birth weights (2856?±?270 versus 3271?±?307 grams) and increased rate of labor inductions (19.8% versus 6.4%) and cesarean deliveries (10.8% versus 5.7%). Despite appropriate birth weight, study group neonates had higher rates of NICU admissions (10.6% versus 6.8%), mechanical ventilation (1.7% versus 0.5%), transient tachypnea of the newborn (1.7% versus 0.5%), hypoglycemia (1.7% versus 0.5%), and jaundice (11.3% versus 7.0%). p?0.01 for all. All remained significant after adjustment to confounders.Conclusions: False diagnosis of FGR is associated with higher rates of induction of labor, cesarean deliveries, and short-term adverse neonatal outcome. 相似文献
102.
Liran Hiersch Liat Salzer Amir Aviram Eran Hadar Eran Ashwal 《The journal of maternal-fetal & neonatal medicine》2017,30(21):2620-2625
Objective: To determine the association between the myometrial electrical activity in the active and second stages of labor at term using electrical uterine myography (EUM).Methods: A prospective observational study of 47 singleton deliveries at term in a tertiary hospital. All women were assessed using noninvasive 9-channel surface electrodes of the EUM during labor. EUM index (EUMi) was calculated as the mean electrical activity during a 30?min monitoring period and expressed as microjouls (MJ). Mean EUMi of the active and second stages of labor were compared accordingly.Results: Mean EUMi during the active phase was 3.53?±?0.43?MJ, whereas mean EUMi in the second stage was 3.66?±?0.48?MJ (p?=?0.02). Correlation analysis between mean EUMi of the active and second stages of labor produced r2?=?0.68 (p?0.01). In a regression analysis model EUMi of the active stage of labor remained strongly correlated with the duration of the second stage (r2?=?0.73, p?0.001). No correlation was found between EUMi and the duration of the second stage.Conclusion: A positive correlation of myometrial electrical activity exists between active phase and second stage of labor. However, while EUMi was associated with the duration of the active phase, no correlation was found between EUMi and the duration of the second stage. 相似文献
103.
Eran Ashwal Amir Aviram Avital Wertheimer Eyal Krispin Boris Kaplan Liran Hiersch 《The journal of maternal-fetal & neonatal medicine》2016,29(18):3024-3029
Objective: Dianatal® is a bioadhesive gliding film which reduces the opposing force to vaginal childbirth. We aimed to investigate the safety, applicability, and impact of Dianatal® obstetric gel on second stage of labor and perineal integrity.Methods: Low-risk singleton pregnancies at term were prospectively enrolled. Eligible women were randomly assigned to either labor management without using obstetric gel, or labor management using intermittent application of obstetric gel into the birth canal during vaginal examinations, starting at active phase of labor (≥4?cm dilation). The primary measured outcome was the length of second stage of labor.Results: Overall, 200 cases were analyzed. Demographic, obstetrical, and labor characteristics were similar between the groups. Neither adverse events nor maternal or neonatal side effects were observed. The mean lengths of the active and second stages of labor were comparable between the obstetric gel-treated and the control groups (157 versus 219 min and 48 versus 56 min, respectively). None of the women had grade III/IV perineal tears. Maternal and neonatal outcomes were not negatively influenced by using obstetric gel. No difference was found after sub-group analysis for spontaneous vaginal delivery.Conclusion: Dianatal® obstetric gel is safe in terms of maternal or neonatal use. Albeit a trend toward shorter labor stages using Dianatal® obstetric gel, no significant differences were noted among the groups. In order to further investigate the influence of the obstetric gel on labor stage interval, perineal integrity and maternal and neonatal outcomes, larger randomized clinical trials are needed to be carried out. 相似文献
104.
Lina Salman Anat Shmueli Amir Aviram Liran Hiersch Rony Chen 《The journal of maternal-fetal & neonatal medicine》2013,26(24):4086-4092
AbstractPurpose: To determine if head circumference (HC) is an independent factor influencing second stage duration stratified by parity and epidural use.Materials and methods: A retrospective cohort analysis of all live, singleton, term (37–42 weeks) vaginal deliveries in one university affiliated medical center (2012–2014). Exclusion criteria included operative deliveries due to fetal distress, major fetal anomalies/chromosomal abnormalities or cases with missing anthropometric data. Maternal demographics, labor characteristics and neonatal anthropometrics including birth weight and HC were retrieved. Multivariate linear regression was utilized to evaluate the association between HC and second stage duration. Analysis was stratified into four groups by parity and epidural use.Results: Of the 16 240 singleton vaginal deliveries during study period, 12 428 deliveries met inclusion criteria. Stratification by parity and epidural analgesia yielded four groups: 3337 (26.9%), 735 (5.9%), 5099 (41.0%) and 3257 (26.2%) deliveries – nullipara with/without epidural and multipara with/without epidural, respectively. In all groups, a large neonatal HC was significantly and independently associated with longer second stage duration: nullipara with epidural (beta 10.06, 95% CI 7.75–12.37), nullipara without epidural (beta 7.58, 95% CI 4.73–10.43), multipara with epidural (beta 4.64, 95%CI 3.47–5.8) and multipara without epidural (beta 1.35, 95% CI 0.76–1.94), p?<?.001 for all. Birth weight was not associated with second stage duration in any of the groups (p?>?.05).Conclusion: Large neonatal HC is significantly associated with longer second stage duration. 相似文献
105.
106.
Markovitch O Tepper R Fishman A Aviram R Cohen I 《Breast cancer research and treatment》2009,113(2):321-326
Background Decrement of endometrial thickness was recorded following short-term aromatase inhibitor treatment in breast cancer patients
previously treated with tamoxifen. It is necessary to verify if long-term aromatase inhibitor treatment can maintain this
phenomenon. Methods Prospective long-term comparison of the last ultrasonographic endometrial thickness measurement taken before discontinuation
of long-term tamoxifen treatment in 64 postmenopausal breast cancer patients, with further repeated measurements, performed
following administration of aromatase inhibitors. Results There was a significant decrement of endometrial thickness, following 36.5 ± 15.7 months of tamoxifen treatment, from a mean
value of 8.7 ± 5.2 mm, measured at the last ultrasonographic measurement performed before discontinuation of tamoxifen treatment,
down to a mean value of 6.2 ± 4.6 mm, measured following 5.3 ± 4.8 months of aromatase inhibitor therapy (P < 0.001). Further ultrasonographic studies revealed the same significant trend. In the first ultrasonographic study performed
during aromatase inhibitor treatment, five (7.8%) patients demonstrated a significant increase of endometrial thickness. Hysteroscopy
revealed a benign endometrial polyp in three patients and atrophic endometrium in the other 2. In 35 patients (54.7%), endometrial
thickness was reduced following the administration of aromatase inhibitors and in 24 patients (37.5%) there was no change
in endometrial thickness. With longer duration of aromatase inhibitor therapy, more patients showed decrement of endometrial
thickness. Conclusions Reversal of endometrial thickening induced by long-term tamoxifen treatment in postmenopausal breast cancer patients is maintained
throughout long-term aromatase inhibitor treatment. 相似文献
107.
Goldberg Y Porat RM Kedar I Shochat C Sagi M Eilat A Mendelson S Hamburger T Nissan A Hubert A Kadouri L Pikarski E Lerer I Abeliovich D Bercovich D Peretz T 《Familial cancer》2008,7(4):309-317
Hereditary non-polyposis colon cancer is caused by mutations in DNA mismatch repair genes. The mutation spectrum in the Israeli
population is poorly documented except for the c.1906G>C Ashkenazi founder mutation in the hMSH2 gene. To report our experience
in HNPCC screening, the mutations detected and the clinical features among a cohort of Israeli patients. Diagnostic work-up
was done in a multi-step process guided by clinical and ethnic information. Tumors of suspected patients were tested for microsatellite
instability and immunohistochemistry. Based on tumor analyses, we proceeded to mutation screening by DHPLC followed by sequence
analysis and multiplex ligase dependent probe amplification. Ashkenazi Jews were first tested for the c.1906G>C founder mutation.
Of the 240 families, 24, including Arabs and Jews from different ethnic origins, were tested positive. All tumors that lost
expression of mismatch repair proteins also showed microsatellite instability. There was evidence for involvement of hMSH2
(15) hMLH1 (6) and hMSH6 (3) genes. Mutations were identified in 17/24 (71%) patients: 6 Ashkenazi families harbored the c.1906G>C
mutation. Eleven other mutations (2 nonsense, 3 splice site and 6 small deletions) were detected. Three of the mutations are
novel. No gross deletions or insertions were detected. This is the first report that characterizes the profile of HNPCC in
a cohort of patients in Israel. Tumor testing indicated that the 3 main MMR genes are involved, and that mutation spectrum
is broad.
相似文献
Yael GoldbergEmail: |
108.
109.
Avishay Golz MD dagger Aviram NetzerMD dagger David Goldenberg MD dagger S. Thomas Westerman MDDagger Liane M. Westerman MADagger Henry Zvi Joachims MD dagger 《American journal of otolaryngology》2001,22(6):391-394
PURPOSE: This study was designed to examine the association between iron-deficiency anemia and the frequency of recurrent acute otitis media in children, and to evaluate the effect of restoring normal hemoglobin levels on the frequency of acute otitis media attacks. MATERIALS AND METHODS: A total of 680 children with frequent episodes of acute otitis media were enrolled in the study. The levels of the hemoglobin were measured in both these children and in 200 healthy children with no history of infections. The correlation between hemoglobin level and the frequency of middle ear infections was studied and analyzed. All children with hemoglobin levels lower than 9.5 g/dL received iron supplementation until they reached a level of at least 11 g/dL, and the subsequent frequency of middle ear infections was recorded. RESULTS: The 680 children had an average of 8.3 +/- 2.7 episodes of acute otitis media per year per child, and an average hemoglobin level of 11.4 +/- 2.7 g/dL, whereas the controls had an average hemoglobin level of 13.1 +/- 2.5 g/dL. Twenty percent had hemoglobin levels below 9.5 g/dL. These children had more episodes of acute otitis media when compared with children with average levels. By increasing the hemoglobin level in these children, the frequency of the episodes of acute otitis media decreased significantly. CONCLUSIONS: This study confirms that anemic children have higher prevalence of episodes of acute otitis media in comparison to healthy, nonanemic children, and shows that there is a direct relationship between the degree of the anemia and the number of the episodes. 相似文献
110.